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373 records returned

Diabetes: treating hypertensionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence)
Source: Clinical Evidence - November 9, 2009 Category: Journals (General) Source Type: journals

HIV: treating tuberculosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Early initiation of highly active antiretroviral treatment Two cohort studies added. One prospective study found mortality was increased the longer HAART initiation was delayed after starting antituberculosis treatment, and found decreased mortality in people with bacteriologically confirmed tuberculosis, who started HAART within the first 120 days of antituberculosis treatment versus people who started HAART later than this. Another study (retrospective from 1996 to 2000; prospective from 2000 to 2004) found better survival in people who started H...
Source: Clinical Evidence - November 5, 2009 Category: Journals (General) Source Type: journals

Burns (minor thermal)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Alginate dressing One systematic review added (search date 2008), which found no RCTs that met Clinical Evidence inclusion criteria. Categorisation unchanged (Unknown effectiveness). Chlorhexidine-impregnated paraffin gauze dressing One systematic review added (search date 2008), which did not pool data, and found no additional RCTs to those previously reported in this Clinical Evidence review. Categorisation unchanged (Unknown effectiveness). Foam dressing One systematic review added (search date 2008),which found no RCTs...
Source: Clinical Evidence - October 27, 2009 Category: Journals (General) Source Type: journals

Alcohol misuseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Single- or multiple-session brief intervention in hazardous or harmful drinkers in primary care One systematic review and one subsequent RCT added comparing single- or multiple-session brief interventions with either control or extended interventions. Categorisation unchanged (Beneficial). Brief intervention (single- or multiple-session) in emergency departments One systematic review and one subsequent RCT added comparing single-session brief intervention (BI) with control. The review found no significant difference between single-session B...
Source: Clinical Evidence - October 26, 2009 Category: Journals (General) Source Type: journals

Renal failure (chronic)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Statins versus placebo or no treatment One systematic review and two subsequent RCTs added. The review found that statins reduced all-cause mortality and cardiovascular mortality compared with placebo or no treatment. The first subsequent RCT found that simvastatin decreased all-cause mortality, major coronary events, and the composite outcome of death from coronary disease and non-fatal MI compared with placebo. The second subsequent RCT found no significant difference between pravastatin and placebo or no treatment in rates of progression to end-s...
Source: Clinical Evidence - October 26, 2009 Category: Journals (General) Source Type: journals

Recurrent throat infections (tonsillitis)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Tonsillectomy versus no surgery in adults One systematic review added identifying one RCT that met Clinical Evidence inclusion criteria. The RCT found that tonsillectomy reduced the frequency and duration of sore throat at 5 to 6 months, but had short follow-up. Categorisation unchanged (Trade-off between benefits and harms). New evidence; conclusion confirmed for: Tonsillectomy versus no surgery in children One systematic review updated (4 RCTs; 564 children), which found that tonsillectomy reduced the number of episode...
Source: Clinical Evidence - October 26, 2009 Category: Journals (General) Source Type: journals

Helicobacter pylori infectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: H pylori eradication treatments (quadruple regimens compared with triple regimens as second-line treatment) New option for which we found three RCTs. The RCTs found that quadruple regimens as second-line therapies were more effective than triple regimens at eradicating H pylori. Most triple regimens given did not contain a nitroimidazole. Categorised as Likely to be beneficial. H pylori eradication treatments (sequential regimens compared with triple regimens as first-line treatment) New option for which we found...
Source: Clinical Evidence - October 1, 2009 Category: Journals (General) Source Type: journals

Warts (non-genital)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Photodynamic treatment One systematic review added. It found that photodynamic treatment was more effective at wart clearance than placebo or cryotherapy, and that neutral red photodynamic treatment and proflavine photodynamic treatment have similar effects. Categorisation unchanged (Likely to be beneficial). Intralesional bleomycin Data from one systematic review updated, and one RCT added. The RCT found that intralesional bleomycin increased wart clearance compared with placebo. Categorisation unchanged (unknown effectiveness). ...
Source: Clinical Evidence - September 24, 2009 Category: Journals (General) Source Type: journals

Herpes labialisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Oral antiviral agents to prevent recurrence One systematic review added (search date 2008),which did not pool data. It found three RCTs and one pooled analysis of two further RCTs that were already reported in this Clinical Evidence review. No new data added from the new review. Categorisation unchanged (Likely to be beneficial). Topical antiviral agents to prevent recurrence One systematic review added (search date 2008), which identified two RCTs. The review did not pool data, and the results of the RCT were reported from the or...
Source: Clinical Evidence - September 23, 2009 Category: Journals (General) Source Type: journals

Hepatitis B (prevention)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Universal vaccination of infants Two observational studies added, which found that universal vaccination of infants reduced the proportion of hepatitis B carriers compared with no vaccination. Categorised as Beneficial. Selective vaccination of high-risk individuals No new evidence on effects of selective vaccination of high-risk individuals. One retrospective cohort study added to harms found no evidence of a link between autoimmune thyroid disease and hepatitis B vaccine. Categorised as Likely to be beneficial. ...
Source: Clinical Evidence - September 23, 2009 Category: Journals (General) Source Type: journals

AmblyopiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Glasses One cohort study added found that visual acuity was better at 1 year in over two-thirds of children who wore glasses. Categorisation unchanged (Likely to be beneficial, based on consensus). Occlusion (patching) Three systematic reviews added identified the same RCTs as previously found by Clinical Evidence. One further RCT identified found no significant difference in visual acuity at 18 weeks between 12 and 6 hours' prescribed occlusion, but added to the evidence for a dose response when actual hours of received...
Source: Clinical Evidence - September 16, 2009 Category: Journals (General) Source Type: journals

Secondary prevention of ischaemic cardiac eventsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Anticoagulants in addition to antiplatelet treatments: Two systematic reviews added comparing intensive warfarin plus aspirin versus aspirin alone. Both reviews found that warfarin plus aspirin decreased the risk of non-fatal MI and stroke, but increased the risk of major bleeding compared with aspirin alone in people with acute coronary syndrome. The evidence supports the recategorisation from Likely to be ineffective or harmful to Trade-off between benefits and harms. Fish oil consumption (from oily fish or capsules): Two systema...
Source: Clinical Evidence - September 7, 2009 Category: Journals (General) Source Type: journals

Obsessive compulsive disorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Behavioural therapy in children and adolescents New option added, for which we found no data satisfying Clinical Evidence inclusion criteria. Categorised as Unknown effectiveness. Cognitive therapy or CBT in children and adolescents New option added, for which one systematic review and two RCTs were added. The systematic review found that CBT improved OCD symptoms versus waiting list control or placebo. However, it found no significant difference between CBT and SRIs. One RCT found no significant difference between intensive once a weekday CBT a...
Source: Clinical Evidence - September 3, 2009 Category: Journals (General) Source Type: journals

Cardiovascular medication: improving adherenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New condition. New option(s) added for: Prompting mechanisms New option. Ten systematic reviews identified (search date 1996;search date 2000;search date 2002; search date 2003; search date 2004 ), which did not pool data. The reviews identified seven RCTs of sufficient quality and we found one subsequent RCT.Five RCTs compared various prompting mechanisms versus usual care; two RCTs compared a prompting mechanism plus usual care versus unit-of...
Source: Clinical Evidence - August 24, 2009 Category: Journals (General) Source Type: journals

Retinal detachmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Corticosteroid injection during vitrectomy surgery New option added for which we identified one RCT. The RCT found no significant difference between adjunctive triamcinolone acetonide and no adjunctive treatment in retinal re-attachment rate or visual acuity at 6 months. Categorised as Unknown effectiveness. Daunorubicin infusion during vitrectomy surgery New option added for which we found two RCTs. Both RCTs found no significant difference between adding daunorubicin and not adding daunorubicin in rate of retinal re-attachment and in visual ac...
Source: Clinical Evidence - August 19, 2009 Category: Journals (General) Source Type: journals

GlaucomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Laser trabeculoplasty plus topical medical treatment (in people with primary open-angle glaucoma, ocular hypertension, or both) One systematic review added. It identified one RCT already included in this Clinical Evidence review, so no new data added. Categorisation unchanged (Likely to be beneficial). Topical medical treatment (in people with primary open-angle glaucoma, ocular hypertension, or both) Two systematic reviews added. One review found reduced visual field loss progression with topical medical treatment (beta-blockers, ...
Source: Clinical Evidence - August 19, 2009 Category: Journals (General) Source Type: journals

Opioid dependenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Buprenorphine for stabilisation: One systematic review that searched for systematic reviews and RCTs added. The systematic review found no new evidence that met our reporting criteria. The systematic review did not perform a meta-analysis for buprenorphine versus placebo but reported that the reviews found buprenorphine was more effective at retaining people in treatment (with higher doses being more effective than lower doses) and at reducing opiate use compared with placebo or no drug treatment. Categorisation of Buprenorphine versus placebo unchanged (Ben...
Source: Clinical Evidence - July 24, 2009 Category: Journals (General) Source Type: journals

Headache (chronic tension-type)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Anticonvulsant drugs New option added, for which we found no systematic review or RCTs. Categorised as Unknown effectiveness. Spinal manipulation (chiropractic and osteopathic treatment) Two systematic reviews and one further RCT added to benefits and harms. One RCT identified by one review found greater reduction in headache severity after treatment with palpatory examination plus osteopathic manipulation versus palpatory examination alone or versus instruction to rest in people with muscle tension-type headache. One RCT identified by...
Source: Clinical Evidence - July 22, 2009 Category: Journals (General) Source Type: journals

Athlete's footEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Topical allylamines (naftifine, terbinafine): One already reported systematic review updated and two RCTs added. The updated review confirmed previous conclusions, and found naftifine and terbinafine were more effective at curing athlete's foot (defined as negative results on microscopy and no growth of dermatophytes in culture) compared with placebo, but not significantly different compared with each other. It found that the results for cure rates between allylamines and azoles were inconclusive. The RCTs found that topical allylamines were more e...
Source: Clinical Evidence - July 20, 2009 Category: Journals (General) Source Type: journals

Delirium at the end of lifeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence)
Source: Clinical Evidence - July 16, 2009 Category: Journals (General) Source Type: journals

Primary prevention of CVD: physical activityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Counselling people to increase physical activity versus no counselling: effects on level of physical activity One systematic review and three RCTs added to the existing reporting of three systematic reviews and 12 RCTs. The added systematic review did not pool data in our group of interest, and the three RCTs were therefore reported separately. Two of the added RCTs found that counselling increased physical activity, whereas the third found no significant difference among groups in physical activity. Categorisation unchanged (Li...
Source: Clinical Evidence - June 25, 2009 Category: Journals (General) Source Type: journals

Osteoarthritis of the hipEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Intra-articular injections (of hyaluronan or corticosteroid) New option for which we found no systematic review or RCTs in people with osteoarthritis of the hip. Categorised as Unknown effectiveness. Hip resurfacing New option for which we found no systematic review or RCTs in people with osteoarthritis of the hip. Categorised as Unknown effectiveness. Arthroscopic debridement New option for which we found no systematic review or RCTs in people with osteoarthritis of the hip. Categorised as Unknown effectiveness. New evidenc...
Source: Clinical Evidence - June 24, 2009 Category: Journals (General) Source Type: journals

Hodgkin's lymphomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: ABVD plus radiotherapy versus radiotherapy alone (stage I or II non-bulky Hodgkin's lymphoma) New option added for which we found one RCT. The RCT found that two cycles of ABVD plus radiotherapy improved freedom from treatment failure (composite outcome), and reduced risk of relapse at 7 years. However, the RCT found no significant difference between treatments in overall survival at 7 years. Categorised as Likely to be beneficial by consensus (ABVD plus radiotherapy is considered the international gold standard for early-stage Hodgkin's lymphoma). New evidenc...
Source: Clinical Evidence - June 15, 2009 Category: Journals (General) Source Type: journals

SidsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Advice to promote room sharing (without bed sharing): We found no direct evidence on the effects of room sharing (without bed sharing) on the prevention of SIDS. Categorised as Unknown effectiveness. New evidence; conclusion confirmed for: Advice to avoid prone sleeping : One retrospective cohort study added assessing the change in incidence of SIDS in the 20 years since advice to avoid prone position sleeping campaign. The study found that factors contributing to SIDS have changed during this time period. Two observational studies ad...
Source: Clinical Evidence - June 5, 2009 Category: Journals (General) Source Type: journals

Sleep apnoeaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Nasal CPAP (severe OSAHS) Three systematic reviews and three subsequent RCTs added comparing nasal CPAP versus placebo, no treatment, or conservative treatment. They found different results on blood pressure with CPAP versus placebo, no treatment, or conservative treatment. They found reduced daytime sleepiness and sleep disturbance, but no significant difference in performance in some neuropsychological test components with CPAP versus placebo, no treatment, or conservative treatment. Categorisation unchanged (Benefic...
Source: Clinical Evidence - June 4, 2009 Category: Journals (General) Source Type: journals

Nausea and vomiting in early pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Acupressure for treating hyperemesis gravidarum: One RCT added, which found that acupressure was more effective at reducing nausea and vomiting episodes compared with placebo and control (conventional intravenous fluid). Categorised as Likely to be beneficial. Metoclopramide for treating hyperemesis gravidarum: One RCT found that metoclopramide was less effective at reducing vomiting episodes and readmission to the intensive care unit compared with corticosteroids. Other drugs and interventions may be more useful. Categorised as Unlikely to be beneficial....
Source: Clinical Evidence - June 3, 2009 Category: Journals (General) Source Type: journals

Partner notificationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Patient-delivered partner therapy New option for which we found one review. The review found that supplementing patient referral with patient-delivered partner therapy reduced risk of recurrent or persistent infection in index patients compared with patient referral alone. Categorised as Likely-to-be-beneficial. Health education plus counselling New option for which we found two reviews. One published RCT identified by the reviews found that more male index patients who received individual counselling plus health education reported that their pa...
Source: Clinical Evidence - May 20, 2009 Category: Journals (General) Source Type: journals

Multiple sclerosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Natalizumab in people with relapsing and remitting multiple sclerosis: Two RCTs identified. One RCT found the proportion of relapse-free people at 2 years was higher with natalizumab compared with placebo. The other RCT also found that the proportion of relapse-free people at 2 years and the cumulative probability of sustained disability progression at 2 years was higher with natalizumab plus interferon beta-1a compared with interferon beta-1a alone. However, the long-term benefits and risks of natalizumab are still unknown. Categorised as Trade-off between bene...
Source: Clinical Evidence - May 14, 2009 Category: Journals (General) Source Type: journals

Ventricular tachyarrhythmias (out-of-hospital cardiac arrests)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Defibrillation (biphasic compared with monophasic shock) New option for which we found five RCTs and one subsequent analysis comparing biphasic versus monophasic defibrillation. The RCTs found no significant differences between groups in survival, but the studies may be underpowered to show clinically important differences. Overall, the evidence found that biphasic shock increased the number of successful defibrillations compared with monophasic shock for out-of-hospital cardiac arrests. Categorised as Likely to be beneficial. (Sourc...
Source: Clinical Evidence - April 24, 2009 Category: Journals (General) Source Type: journals

Kidney stonesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Alpha-blockers in people with symptomatic ureteric stones New option for which we found two systematic reviews and three subsequent RCTs, which all found that alpha-blockers increased the proportion of people with expelled stones compared with placebo at times ranging from 1 to 7 weeks. However, both systematic reviews reported heterogeneity among RCTs. Categorised as Likely to be beneficial. New evidence; conclusion confirmed for: Extracorporeal shockwave lithotripsy (ESWL) in people wi...
Source: Clinical Evidence - April 21, 2009 Category: Journals (General) Source Type: journals

Lung cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Preoperative chemotherapy in resectable non-small cell lung cancer Two systematic reviews and one subsequent RCT added comparing preoperative chemotherapy versus surgery alone. The first review found that preoperative chemotherapy significantly increased 5-year survival compared with surgery alone. The second review found that preoperative chemotherapy significantly increased survival at 1 and 3 years, but not at 5 years compared with surgery alone. The subsequent RCT found no significant difference between groups for 5-year survival. Categorisation...
Source: Clinical Evidence - April 21, 2009 Category: Journals (General) Source Type: journals

Tubal ectopic pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Salpingectomy: One retrospective cohort study added comparing expectant management versus salpingectomy. It found that salpingectomy did not increase the rate of subsequent pregnancy compared with expectant management. Categorisation unchanged (Beneficial). Salpingotomy: One systematic review updated, comparing salpingotomy by laparoscopy versus salpingotomy by laparotomy. It found that laparoscopy was less effective in achieving primary treatment success (elimination of tubal pregnancy) than laparotomy. However, it found no significant dif...
Source: Clinical Evidence - April 20, 2009 Category: Journals (General) Source Type: journals

Schizophrenia (maintenance treatment)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Compliance therapy One systematic review added found no significant difference in the proportion of non-compliant people between those receiving compliance therapy and those receiving non-specific counselling therapy over 1 year. One RCT comparing adherence therapy versus health education found no significant difference between groups in either patient-rated or keyworker-rated measures of compliance at 12 months. Reassessment of evidence resulted in change of categorisation from Likely to be beneficial to Unknown effectiveness. New evidence; conc...
Source: Clinical Evidence - April 16, 2009 Category: Journals (General) Source Type: journals

Stress incontinenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Serotonin reuptake inhibitors (duloxetine) One systematic review updated to now include one further RCT. One subsequent RCT added, which found reduced incontinence episode frequency but no significant improvement in quality of life with duloxetine compared with placebo. Categorisation changed (Beneficial to Likely to be beneficial). Non-tension-free vaginal tape/transobturator foramen tape suburethral slings One systematic review updated. One RCT added comparing suburethral slings other than tension-free vaginal tape (TVT) versus open retrop...
Source: Clinical Evidence - April 14, 2009 Category: Journals (General) Source Type: journals

Tuberculosis (HIV-negative people)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Rifampicin plus isoniazid Two subsequent RCTs added to the existing reporting of one systematic review. One of the subsequent RCTs (470 people) was quasi-randomised, and the other RCT was small (105 people). Categorisation unchanged (Trade-off between benefits and harms). Regimens containing quinolones One already reported systematic review updated (search date 2007) to now include one further RCT, which was already reported in this review. Reporting in benefits and harms enhanced. Two other systematic reviews added (search dates 2...
Source: Clinical Evidence - April 14, 2009 Category: Journals (General) Source Type: journals

Sickle cell diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Blood transfusion (prophylactic) sickle cell disease New option for which we found one systematic review identifying two RCTs. The review found that prophylactic blood transfusion significantly reduced the rate of stroke compared with standard care or no transfusion at 16–24 months. Categorised as a Trade-off between benefits and harms. New evidence; conclusions changed for: Piracetam for sickle cell disease We found one systematic review comparing piracetam versus placebo. The review included three RCTs, but only one was reported ...
Source: Clinical Evidence - March 27, 2009 Category: Journals (General) Source Type: journals

Leg crampsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Vitamin E for leg cramps in pregnancy New option for which we identified no RCTs. Categorised as Unknown effectiveness. New evidence; conclusions changed for: Quinine A drug safety alert has been issued by the FDA advising manufacturers to stop marketing unapproved drug products containing quinine, because of serious safety concerns. Among the adverse effects of quinine are cardiac arrhythmias, thrombocytopenia, severe hypersensitivity reactions, and death. Because of these serious adverse effects, and because the toxic dose for quini...
Source: Clinical Evidence - March 26, 2009 Category: Journals (General) Source Type: journals

Herniated lumbar discEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Cytokine inhibitors Follow-up data for 1 year was added to the RCT comparing infliximab versus placebo, and found no significant difference in pain, disability, cumulative sick leave, or proportion of people having discectomy. Categorisation unchanged (unknown effectiveness). Spinal manipulation One RCT added comparing manipulation alone versus acupuncture plus manipulation. Evaluated after 20 sessions, it found manipulation alone was less effective at improving pain. Categorisation unchanged (likely to be beneficial). Acu...
Source: Clinical Evidence - March 26, 2009 Category: Journals (General) Source Type: journals

Candidiasis (oropharyngeal)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Antifungal prophylaxis in adults having chemotherapy or radiotherapy One systematic review updated, which identified no additional RCTs. Categorisation unchanged (Beneficial). Antifungal treatment in adults having chemotherapy and radiotherapy One systematic review updated which identified no additional RCTs. Categorisation unchanged (Unknown effectiveness). Antifungal prophylaxis in people with HIV infection One systematic review added comparing antifungal prophylaxis versus placebo. It found that fluconazole, it...
Source: Clinical Evidence - March 18, 2009 Category: Journals (General) Source Type: journals

Trigeminal neuralgiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Ablative neurosurgical techniques to the Gasserian ganglion (retrogasserian percutaneous radiofrequency thermocoagulation, glycerol rhizolysis, or balloon compression: New option for which we found no RCTs. Categorised as Unknown effectiveness, although there is some observational evidence suggesting that radiofrequency thermocoagulation may offer higher rates of complete pain relief than glycerol rhizolysis and stereotactic radiosurgery, although it is also associated with the highest rate of complications. New evidence; conclusions changed for: ...
Source: Clinical Evidence - March 12, 2009 Category: Journals (General) Source Type: journals

Brain metastasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New condition. New option(s) added for: Corticosteroids New option. One systematic review found (search date 2003) which identified no RCTs comparing corticosteroids versus no corticosteroids.Three systematic reviews found (search date 2003, search date 2004) which identified the same small RCT (48 people) comparing corticosteroids versus corticosteroids plus whole-brain radiotherapy. 'Corticosteroids' categorised as Likely to be beneficial (categorisation made by consensus as insufficient RCT evidence found). Cytotoxic chemotherapy (systemic) New option. Three R...
Source: Clinical Evidence - March 12, 2009 Category: Journals (General) Source Type: journals

InfluenzaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Amantadine (oral) chemoprophylaxis One systematic review added comparing amantadine versus placebo in people aged up to 18 years, and in elderly people.None of the RCTs included in the review met our inclusion criteria. Amantadine has been associated with insomnia, hallucinations, and agitation. There is also consensus that amantadine should not be used for first-line chemoprophylaxis, because resistance to amantadine is high and it is only effective against influenza A. Categorisation changed (from Likely to be ineffective or harmful to Trade-off between ben...
Source: Clinical Evidence - March 12, 2009 Category: Journals (General) Source Type: journals

BunionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: Different Methods of bone fixation One RCT addedcomparing percutaneous Kirschner-wire fixation with internal screw fixation following distal chevron osteotomy found no significant differences between functional status or radiological findings at 6 months' follow-up.Categorisation unchanged (Unknown effectiveness). Distal metatarsal osteotomy Two subsequent RCTs added: One RCT comparing Lindgren osteotomy with distal chevron osteotomy found significant improvements in radiological outcomes with Lindgren osteotomy compared with dista...
Source: Clinical Evidence - March 11, 2009 Category: Journals (General) Source Type: journals

Anorexia nervosaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study had a high withdrawal rate, which limits the conclusions that can be drawn. Categorisation unchanged (Unknown effectiveness). SSRIs Three systematic reviews added, which did not pool data, and which identified three RCTs comparing fluoxetine or citalopram versus placebo which were previously reported in this review. No new data added from the reviews. One RCT comparing fluoxetine plus CBT versus placebo plus CBT added which had a high withdrawal rate which limited any conclusions that could be drawn. Categorisation unchanged (Unknown effectiveness). Anxiolyt...
Source: Clinical Evidence - March 10, 2009 Category: Journals (General) Source Type: journals

CroupEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusions changed for: Dexamethasone (oral) versus prednisolone (oral) in children with moderate to severe croup One RCT added comparing prednisolone versus dexamethasone 0.6 mg/kg versus dexamethasone 0.15 mg/kg, all given orally. It found no significant difference among the groups in hospital admission or in the need for further medical attention. Categorisation changed (Unknown effectiveness). New evidence; conclusion confirmed for: Dexamethasone (oral), higher dose versus lower dose in children with moderate to severe croup One RCT added...
Source: Clinical Evidence - March 10, 2009 Category: Journals (General) Source Type: journals

ThromboembolismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Self-testing and self-management of oral anticoagulation One systematic review and two subsequent RCTs added comparing self-management of oral anticoagulation versus usual care.Clinical outcomes such as mortality or recurrence were not assessed by the review It found that self-management significantly increased the proportion of INR results in the therapeutic range at 6–24 months.The first RCT found no significant difference in proportion of time spent within the INR therapeutic range between groups at 6 months.The second RCT found that self-management of oral anticoagul...
Source: Clinical Evidence - March 9, 2009 Category: Journals (General) Source Type: journals

Intimate partner violence towards womenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence)
Source: Clinical Evidence - February 13, 2009 Category: Journals (General) Source Type: journals

HaemorrhoidsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Radiofrequency ablation New option. Two RCTs comparing radiofrequency ablation versus open haemorrhoidectomy, and one RCT comparing radiofrequency ablation versus rubber band ligation added.Radiofrequency ablation categorised as Unknown effectiveness. New evidence; conclusions changed for: Stapled haemorrhoidectomy Six systematic reviews added (search date 2002;search date 2004; search date 2006 ), one 7-year follow-up of an included RCT added, and five subsequent RCTs ...
Source: Clinical Evidence - January 29, 2009 Category: Journals (General) Source Type: journals

EpilepsyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New option(s) added for: Lamotrigine (partial epilepsy) One systematic review and one RCT added. The systematic review found that, compared with carbamazepine, lamotrigine was associated with a lower risk of treatment failure, and increased the proportion of people who were seizure free at 6 months. The RCT found lamotrigine was less likely to lead to treatment withdrawals caused by adverse effects compared with gabapentin, but we don't know whether it is more effective at increasing the proportion of people seizure free at 3 months. Categorisation amended to Likely to be beneficial by consensus (...
Source: Clinical Evidence - January 28, 2009 Category: Journals (General) Source Type: journals

Postnatal depressionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New evidence; conclusion confirmed for: SSRIs 3 systematic reviews added, which did not perform a meta-analysis. They identified no additional RCTs. Categorisation unchanged (Likely to be beneficial). CBT (group) Two systematic reviews added, which did not perform a meta-analysis. They identified no additional RCTs. Categorisation unchanged (Unknown effectiveness). Interpersonal psychotherapy 3 systematic reviews added, which did not perform a meta-analysis. They identified no additional RCTs. Categorisation unch...
Source: Clinical Evidence - January 26, 2009 Category: Journals (General) Source Type: journals